Breast Cancer Research and Treatment

, Volume 108, Issue 1, pp 69–77 | Cite as

Symptom management after breast cancer treatment: is it influenced by patient characteristics?

  • Jean Yoon
  • Jennifer L. Malin
  • Diana M. Tisnado
  • May Lin Tao
  • John L. Adams
  • Martha J. Timmer
  • Patricia A. Ganz
  • Katherine L. Kahn
Clinical Trial


Purpose With improved patient survival from breast cancer, more interest has evolved regarding the symptoms women experience in association with breast cancer treatments. We studied the extent to which symptoms for women with incident breast cancer are addressed by their physicians and how symptom management varies with patient characteristics. Methods As part of the Los Angeles Women’s (LAW) Study, we categorized women from a population-based study of incident breast cancer (n = 1,219) as having an unmet need if she had at least one severe symptom (any of the following: nausea/vomiting, arm problems, hot flashes, vaginal dryness, difficulty sleeping) for which she did not receive the help she wanted. Multivariable analyses predicted having any unmet need as a function of patient demographic and health characteristics. Results The prevalence of unmet need varied by the type of symptom with the highest proportion of women receiving help for nausea and vomiting (0.91) and the lowest for vaginal dryness (0.48). Black women (OR = 3.61, 95% CI: [1.57, 8.31]), and Spanish-speaking Hispanic women (OR = 2.69, 95% CI: [1.22, 5.94]) were significantly more likely than white women to report an unmet need. More black and Hispanic women compared to white women cited the doctor not thinking treatment would benefit her (P = 0.02), not appreciating how much the problem bothered her (P = 0.03), not knowing about treatments (P < 0.0001), or insurance/cost barriers (P = 0.009) as reasons for her unmet need. Conclusion These results show the persistence of racial disparities in the receipt of appropriate care within the health care system.


Breast cancer Disparities Quality of care Symptom management 



We would like to acknowledge Dennis Deapen, MD, Donna Morell, and Ann Hamilton for assistance in using the Los Angeles County SEER Rapid Case Ascertainment (RCA) program. Financial support: National Cancer Institute Grant # R01 CA 81338-01A1. Dr. Ganz was also supported by an American Cancer Society Clinical Research Professorship award. Dr. Malin was supported by a CI-10 Damon Runyon-Lilly Clinical Investigator Award from the Damon Runyon Cancer Research Foundation.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Jean Yoon
    • 1
  • Jennifer L. Malin
    • 2
  • Diana M. Tisnado
    • 3
  • May Lin Tao
    • 4
  • John L. Adams
    • 5
  • Martha J. Timmer
    • 5
  • Patricia A. Ganz
    • 6
    • 7
  • Katherine L. Kahn
    • 3
    • 5
  1. 1.School of Public Health, Health Services DepartmentUniversity of California at Los AngelesLos AngelesUSA
  2. 2.AmgenThousand OaksUSA
  3. 3.Division of General Internal Medicine and Health Services Research, School of MedicineUniversity of California at Los AngelesLos AngelesUSA
  4. 4.Valley Radiotherapy Associates Medical GroupEl SegundoUSA
  5. 5.RANDSanta MonicaUSA
  6. 6.School of Public Health and School of MedicineUniversity of California at Los AngelesLos AngelesUSA
  7. 7.Jonsson Comprehensive Cancer Center at UCLALos AngelesUSA

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